- 4009 Hackney Springs Ln, Sachse, TX 75048
| STATES / TERRITORIES | PHONE · PORTAL | CLAIM VOLUME | BENEFICIARIES |
|---|---|---|---|
| 1-855-252-8782 · Novitasphere JL | ~200 million claims/year | ~3.4 million Medicare FFS |
J8 is a MolDX jurisdiction. Any lab billing molecular diagnostic tests, CPT codes in the 81XXX range, or most PLA codes needs an active DEX Z-Code from Palmetto GBA’s DEX platform (dexzcodes.com) registered before those claims go out the door
WPS applies LCD L35025 — MolDX: Molecular Diagnostic Tests (MDT) — to govern Z-Code requirements for molecular and genetic tests billed in J8, the same policy WPS applies in J5. Submit a Test Coverage Review at dexzcodes.com before billing, and confirm the current LCD text through the Medicare Coverage Database.
Claims without a valid Z-Code are denied automatically, with no manual override at the claims level. Confirming your DEX Z-Code registration is current, for every 81XXX-range code your lab bills, is a prerequisite for reimbursement, not an optional compliance step.
| LCD | Coverage Area | Key Requirement |
|---|---|---|
| L35025 | MolDX: Molecular Diagnostic Tests (MDT) | Governs Z-Code requirements for molecular and genetic tests billed in J8. Submit a Test Coverage Review at dexzcodes.com before billing. |
| L35062 | Glycated Hemoglobin (HbA1c) | Quarterly coverage for stable diabetics; same policy WPS applies in J5. |
| L35095 | Vitamin D Assay | Coverage requires a documented deficiency or at-risk condition; same framework as J5. |
| L35396 | Tumor Markers | Michigan's oncology volume makes this a high-priority LCD for labs serving cancer centers. |
| L34752 | Urine Drug Testing | Presumptive and definitive drug testing require documented medical necessity. Michigan pain management scrutiny has intensified following opioid crisis legislation. |
| L35099 | Non-Covered Lab Services | ABN protocol required; WPS has active pre-payment review for labs with elevated non-covered test billing. |
| Test | CPT | Frequency Limit |
|---|---|---|
| HbA1c | 83036 | Quarterly for stable diabetics; monthly for newly diagnosed or treatment-change patients |
| Urine Drug Screen, presumptive | 80305-80307 | Per clinical protocol; MAC scrutiny on labs billing more than monthly per patient |
| Vitamin D | 82306 | Annual unless therapeutic monitoring is documented |
| Comprehensive Metabolic Panel | 80053 | No fixed limit — documentation-driven |
Urine drug screen billing — frequency and documentation gaps in Michigan’s pain management market.
CMP component vs. panel miscoding — the same billing pattern that shows up across WPS’s jurisdictions.
Vitamin D testing documentation — screening billed without the supporting ICD-10.
Molecular Z-Code compliance — an emerging review area given confirmed MolDX participation.
| Area | Requirement |
|---|---|
| Provider Enrollment | CMS-855B (independent lab) or CMS-855A (hospital outpatient). Submit to the WPS enrollment unit. Re-enrollment and revalidation notices go to the address on file — keep it current. |
| ABN Requirements | Required before any test expected to be denied — particularly Vitamin D without supported ICD-10, drug testing beyond protocol frequency, and molecular tests without a confirmed Z-Code. |
| CLFS / Fee Schedule | If J8 is absorbed into a new 'Jurisdiction Q,' the new MAC's CLFS implementation procedures will apply. Existing contracted rates and enrollment are expected to carry over but should be verified. |
Labs lose revenue to preventable denials; miscoded panels, missed modifiers, payer-specific mismatches. TransLabs built its billing process around what labs actually need to get paid, coast to coast. Start with a complimentary claims audit. We’ll review your CPT/HCPCS coding, test methodology, and denial trends to show you exactly what’s recoverable.
Claims checked against your MAC's local coverage rules before submission.
Medicaid and commercial prior-auth rules built into your workflow, not discovered after denial.
Appeals strategy built from denial data across all 50 states.
A dedicated billing specialist; never a shared call queue.
Live in 24 hours. No contracts. No upfront fees.
Yes. J8, administered by WPS, is a MolDX jurisdiction. Labs billing molecular diagnostic tests in the 81XXX range or most PLA codes must hold an active DEX Z-Code from Palmetto GBA before submitting claims.
The claim is denied automatically. There's no manual override at the claims level, which is why Z-Code registration has to happen before billing.
Indiana and Michigan. WPS processes J8 (and J5) claims through the Mediweb portal.
Quarterly for stable diabetic patients under LCD L35062, the same policy WPS applies in J5. More frequent billing needs documentation of a treatment change or new diagnosis.
CMS has proposed merging J8 with J15 into a new 'Jurisdiction Q.' The J8 contract's anticipated end date (October 2025) has passed with no confirmed outcome in TransLabs' tracking — reverify current status at cms.gov.
CMS-855B for independent labs, submitted to the WPS enrollment unit. Hospital outpatient labs use CMS-855A instead.
